Posted by policebox on May 10, 2012, at 1:42:22
In reply to Melancholic vs Atypical depression, posted by psychobot5000 on May 8, 2012, at 23:59:45
I can't see how you could be have both melancholic and atypical depression, as the diagnoses are mutually exclusive.
Melancholia involves the inability to find pleasure in positive things and lack of mood reactivity. Melancholic depression generally involves weight loss or loss of appetite and insomnia.
Whereas atypical depression involves mood reactivity in that you are able to feel an improved mood in response to positive events. Atypical depression has a triad of reversed vegetative symptoms, specifically over-eating, hypersomnia, and accute sensitivity to interpersonal rejection (which is another form of mood reactivity).
I'd base a diagnosis on what you experience most of the time. If you mostly fit melancholic, then I'd say you have that. If you mostly fit atypical, then I'd say you have that.
Although I sometimes lose my appetite when I'm particularly upset or sometimes my mood doesn't improve despite positive events, I am largely atypical the vast majority of the time.
> What the hell does it mean if you meet the criteria for both melancholic and atypical depression?
>
> I know there's an exclusion under atypical for patients who are melancholic, but this strikes me as arbitrary, especially since so many of the gritty details of atypical depression fit me so well.
>
> Does anyone know how much evidence we have that these categories are actually useful for diagnosis, treatment, or...anything? Are the distinctions valid? If so, are the prescriptions (biologically based treatment (i.e. drugs and neuronstimulation?) for melancholic depression...everything in the bag for atypical, but among medications, look to MAOis) actually useful?
> F*ck this noise,
> Psychobot5000
poster:policebox
thread:1017453
URL: http://www.dr-bob.org/babble/20120508/msgs/1017598.html